KERRY A OKELBERRY O D P C (NPI# 1639264427) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639264427 |
| Entity Type | Organization |
| Organization Name | KERRY A OKELBERRY O D P C |
| Other Organization Name | REDWOOD VISION CENTER |
| Practice Address |
6705 Redwood Rd West Jordan UT 84084-2402 |
| Practice Telephone | 8012680866 |
| Practice Fax Number | 8012682092 |
| Mailing Telephone | 8012680866 |
| Mailing Fax Number | 8012682092 |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2014-02-05 |
| Authorized Official Name | DR. KERRY A. OKELBERRY (PRESIDENT) |
| Authorized Official Telephone | 8012680866 |
| Authorized Official Credential | O.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332H00000X | Eyewear Supplier (Equipment, not the service) | 1125139934 | UT | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| UT | 528904440008 | 05 | |
| UT | RETIRED RAILROAD MEDICARE | DR3610 | 01 |
| Other Name | Type Code |
|---|---|
| Redwood Vision Center | Doing Business As Name - Organization |
| Street Address |
6705 REDWOOD RD |
| City | WEST JORDAN |
| State | UT |
| Zip Code | 84084-2402 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013928118 | Kerry Allen Okelberry | Optometrist | 6705 Redwood Rd, West Jordan, UT 84084-2402 | 2006-08-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396351383 | National Vision Inc | Optometrist | 3857 West Campus View Drive, Suite 110, West Jordan, UT 84084 | 2020-09-16 |
| 1386267938 | Parker Brown | Dentist | Jordan Valley Dental, 7452 S Campus Drive, West Jordan, UT 84084 | 2020-05-18 |
| 1952809873 | David D. Allred Counseling & Consulting, LLC | Marriage & Family Therapist | 1365 W Green Hedge Way, West Jordan, UT 84084 | 2018-01-25 |
| 1720514268 | Utah Podiatric Physicians and Surgeons Group LLC | Podiatrist | 7000 S 1561 W, #100, West Jordan, UT 84084 | 2017-05-03 |
| 1245787829 | Josh Sullivan | Social Worker | 7395 S Paddington Rd, West Jordan, UT 84084 | 2016-09-01 |
| 1457752503 | Eaze Bracing | Prosthetic/Orthotic Supplier | 1324 W 7125 S, West Jordan, UT 84084 | 2014-09-09 |
| 1437595030 | Medico Transport System | Ambulance | 7365 S 4570 W, South Jordan, UT 84084 | 2013-05-22 |
| 1659612737 | Lifecare Specialty | Pharmacy | 1646 Sunrise Place Ste B, West Jordan, UT 84084 | 2013-03-14 |
| 1518217942 | Luciane Lopes De Oliveira | Student in an Organized Health Care Education/Training Program | 7601 Redwood Road, West Jordan, UT 84084 | 2012-09-13 |
| 1023368636 | Chelsey Tautkus | Social Worker | 7601 South Redwood Road, Building E, West Jordan, UT 84084 | 2012-09-12 |
| Find all providers in zip 84084 | ||||
| Taxonomy Code | 332H00000X |
| Grouping | Suppliers |
| Classification | Eyewear Supplier (Equipment, not the service) |
| An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407412885 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 1520 W 9000 S Ste E, West Jordan, UT 84088-8001 | 2019-05-11 |
| 1578987160 | Luxottica of America Inc. | Eyewear Supplier (Equipment, not the service) | 7083 S Plaza Center Dr, Suite K-2a, West Jordan, UT 84084-1762 | 2014-02-18 |
| 1073663290 | Luxottica Retail North America Inc | Eyewear Supplier (Equipment, not the service) | 7453 Plaza Center Dr, West Jordan, UT 84084-4323 | 2007-01-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053935882 | Eyemart Express LLC | Eyewear Supplier (Equipment, not the service) | 15 S River Rd # 150, St George, UT 84790-2106 | 2020-06-08 |
| 1265088074 | Eyemart Express LLC | Eyewear Supplier (Equipment, not the service) | 846 Expressway Ln, Spanish Fork, UT 84660-1300 | 2019-08-16 |
| 1043876428 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 2843 S 5600 W Ste 170, West Valley City, UT 84120-6089 | 2019-05-11 |
| 1134785512 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 2035 Harris Blvd Ste C, Layton, UT 84041-1655 | 2019-05-11 |
| 1124584529 | Eyemart Express LLC | Eyewear Supplier (Equipment, not the service) | 1986 N Hill Field Rd Ste 5, Layton, UT 84041-2112 | 2019-02-11 |
| 1003383803 | Jand. Inc. | Eyewear Supplier (Equipment, not the service) | 918 E 900 S, Salt Lake City, UT 84105-1402 | 2018-10-30 |
| 1356826010 | Eyemart Express LLC | Eyewear Supplier (Equipment, not the service) | 4115 Riverdale Rd, Ogden, UT 84405-3509 | 2018-09-28 |
| 1003398025 | Eyemart Express LLC | Eyewear Supplier (Equipment, not the service) | 366 E University Pkwy, Orem, UT 84058 | 2018-09-06 |
| 1790225696 | Luxottica of America Inc | Eyewear Supplier (Equipment, not the service) | 6117 S State St, Murray, UT 84107-7343 | 2017-02-27 |
| 1841681384 | Costco Wholesale Corporation | Eyewear Supplier (Equipment, not the service) | 3571 W 10400 S, South Jordan, UT 84095 | 2015-02-05 |
| Find all providers with the same taxonomy | ||||
| City | WEST JORDAN |
| Zip Code | 84084 |
Please comment or provide details below to improve the information on KERRY A OKELBERRY O D P C.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.